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Billing code 21556: Tumor excisionMedicare rate & RVUs

Report this service for excision of a subfascial soft-tissue tumor in the neck or anterior thorax when the tumor measures less than 5 cm.

CMS RVU26DEffective Oct 1, 2026109 payment localities2K Medicare services in 2024

Medicare pays $491.33 for 21556 nationally in a facility.

Medicare rate · 21556

Tumor excision

Swap in your local Medicare rate.

Work RVUs
7.47
Total RVUs
14.71
Global days
090

National rate · 2026

$491.33

Facility setting, before claim adjustments.

See every locality for 21556 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 21556 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21556 covers

This code describes removal of a soft-tissue tumor beneath the superficial fascia, such as a lesion within muscle, in the neck or anterior thorax. It is used when the surgeon excises the tumor and its size is under 5 cm. Head and neck surgeons and general surgeons may perform the procedure in an operating room or another setting equipped for surgical excision. The code is for a deep tumor, not a subcutaneous lesion or a limited diagnostic sample.

Choose the code based on the tumor’s depth, location, size, and the work actually performed. Document the anatomic site, subfascial plane, tumor measurement, and extent of removal; distinguish excision from a more extensive resection. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 21556 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21556 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$445.82
Alaska*Unavailable$606.39
ArizonaUnavailable$478.24
ArkansasUnavailable$440.23
AtlantaUnavailable$505.09
AustinUnavailable$497.35
BakersfieldUnavailable$495.21
Baltimore/Surr. CntysUnavailable$521.08
BeaumontUnavailable$470.50
BrazoriaUnavailable$480.72

21556 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
21556 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21556 rate is calculated

Each of 21556’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21556

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.47Practice expense 5.76Malpractice 1.48

14.7100 adjusted RVUs×$33.4009 conversion factor=$491.33

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21556

21556 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21556

Tumor excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21556

Tumor excision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21556 without 51 · national facility

$491.33

Tumor excision

21556-51 · Second procedure: 50%

$245.67

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

21556 compared with similar codes

Compare codes

21556 vs 21554 vs 21557 vs 21552 vs 21550: national Medicare rates

Swap in your local Medicare rate.

  • 21556
    Tumor excision · 7.47 wRVU
    —
  • 21554
    Tumor excision · 10.85 wRVU
    —
  • 21557
    Tumor resection · 14.38 wRVU
    —
  • 21552
    Soft-tissue excision · 6.33 wRVU
    —
  • 21550
    Soft-tissue biopsy · 2.06 wRVU
    $271.88

How to choose

21554Tumor excision
This code applies to a deep soft-tissue tumor under 5 cm; 21554 is for a tumor 5 cm or larger.
21557Tumor resection
Both involve a deep soft-tissue tumor under 5 cm, but 21557 represents resection rather than excision.
21552Soft-tissue excision
21552 is for a subcutaneous lesion 3 cm or larger. Use 21556 when the tumor is beneath the superficial fascia.
21550Soft-tissue biopsy
21550 represents biopsy for diagnostic sampling. This code represents excision of a deep tumor under 5 cm.

Codes related to 21556

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21556
CodeHow it relatesNational office range
Same family
21554Tumor excisionDeep soft-tissue tumor excision for tumors 5 cm or larger.No office rate
Used instead
21557Tumor resectionFor a more extensive resection of a deep soft-tissue tumor under 5 cm.No office rate
21558Tumor resectionFor a more extensive resection of a deep soft-tissue tumor 5 cm or larger.No office rate
21552Soft-tissue excisionFor excision of a subcutaneous neck or anterior thorax lesion 3 cm or larger.No office rate
21555Mass excisionFor excision of a subcutaneous neck or anterior thorax lesion under 3 cm.$406.13–$599.45
21550Soft-tissue biopsyFor biopsy of a neck or chest lesion when sampling, rather than excision, is performed.$239.80–$360.13

21556 billing questions

How does this differ from 21554?

Both describe deep soft-tissue tumor excision in the neck or anterior thorax. Use 21556 for a tumor under 5 cm and 21554 for one 5 cm or larger.

When would 21552 or 21555 be more appropriate?

Those codes describe excision of a subcutaneous lesion. This code is for a tumor beneath the superficial fascia, such as one within muscle.

Can a diagnostic biopsy of the same tumor be reported with the excision?

When the tumor is excised during the same session, a separate biopsy of that same lesion generally is not separately reported as an additional procedure.

What documentation supports reporting 21556?

Record the neck or anterior thorax site, the tumor’s subfascial location, its size, and the extent of excision. The record should support that the tumor measures less than 5 cm.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21556PPRRVU2026_Oct_nonQPP.csv, line 2,005 (RVU26D)

Open CMS sourceHow we calculate rates

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